172
FOIL Ser. #:
Chris Masterson 0
Christine Fulton 0
Sue Rose ~
L/ i./l.{L
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2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REQUEST
FOR ThITERNAL USE ONLY
Received by:
DEPARTMENT: \.---/'
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT 0
PLANNING 0
ZONING 0
FIRE INSPECTOR 0
HIGHNVAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
W A TERlSEWER 0
DOG CONTROL OFFICER 0
TOWN ENGINEER 0
TOWN ATIORNEY 0
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Date Received:
FOR DEPARTMENT USE ONLY
Date Applicant Contacted:
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Date Received by Dept
Department Head approval:
Date FOIL fulfilled or denied: ~ 1 .:L 1 1JL
Closed by:
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Date:
Notes: (~~~y C(}0~~
Amount Due: Pages for total of S
Agency or firm:
Telephone #: (
Email address:
o check here if you are
requesting that the records
be mailed to this address.
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SPEqFIC DESCRIPTlQN OF RECORQ; '\ ,
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FORMAT OF RECORD (if available)
o I request to be notified when I can come to inspect the record(s) described above
o I request copies of the records described above and agree to pay the cost of such records in
accordance with the fee schedule on the back of this application
o I request that the records be sent via e-mail to the address listed above
o I request that the records be faxed to the number listed above